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Flush with Pride

By Debra Meiburg MW

With the lantern festival just behind us and today marking the start of the much-anticipated Chinese National Week, many of us in this part of the world are probably getting into the mood with a little red of our own, maybe even popping the cork on a bottle of Chairman Mao (the local nickname for Mouton-Rothschild, for the dirty-minded among you whose thoughts drifted in other directions). But for some of us, the red faces we’ll be more concerned about are our own.

For half of Asia, a red face means mom and dad short-changed you in the aldehyde dehydrogenase (ALDH) gene pool. ALDH is an enzyme that breaks down alcohol in our systems. Well, not alcohol exactly. First, the alcohol is metabolized into acetaldehyde – otherwise known as the hangover compound. Acetaldehyde is toxic, but when ALDH takes a swipe at it, the tough hangover warrior metamorphoses into harmless vinegar.

Thanks to an ancient genetic mutation, about 50% of Asia was born with only a small reserve of ALDH. Low levels of ALDH mean alcohol can trigger an embarrassing rosy cheeked reaction. Though commonly known as the Asian flush, Asian explosion or the Asian glow, a considerable portion of the Jewish community is also prone to the blush. Contrary to popular opinion, the red cheeks are not a sign of drunkenness – not quite. The toxic build up of acetaldehyde causes our capillaries to dilate (vasodilation), which results in flushing on the face, neck and shoulders and potentially every part of the body except the feet. This reaction is similar to when a person is exposed to extreme heat or excessive exercise. Also, some foods have a tendency to cause vasodilation, such as chillies, eggplant, tomatoes and walnuts. While a red face can be disconcerting, for many people that’s only the preliminary reaction. Rosy cheeks can be followed by an increased heart rate, low blood pressure, headache, hyperventilation and nausea.

There are a number of “urban legend’’ attempts to quell the reaction, such as sucking on ice chips or by taking aspirin or antacid tablets. Never take aspirin with alcohol because it interferes with the preliminary breakdown of alcohol. Especially never take acetaminophens while drinking as they can cause serious liver damage.

The latest fad is to take heart-burn medicines, such as Zantac or Peptic AC to combat the flush. Like any popular remedy, users swear by it – noting the tablets have to be taken about 30 minutes before consuming alcohol to be effective. There is little research on this topic because – as the research community will readily admit – there’s no medical imperative to make it easier for people to overindulge in alcohol. It is thought that Zantac and similar medications act as an antihistamine, calming the skin’s reaction, but don’t be fooled – if it works – these meds are only masking the symptoms, not the cause.

There’s a bright side to the glow: alcoholism is exceedingly low amongst Asians. The flush and its associated maladies are such a deterrent to overindulging, drugs such as Antabuse that mimic these effects are given to recovering alcoholics. While some Facebook groups are promoting Asian flush pride, it is best to listen to your body as it is trying to prevent you from harming yourself. On the other side of the world, October 1st marks the date that US citizens can start for their 2014 health insurance, so those of us in the 852 who tend to get a little rosy might try celebrating our relatively uncomplicated healthcare system by trading in the hong jau (red wine) for some hong cha (red tea), if only for the week.